Precautions After Splenectomy

What do you do with a lung cancer patient who lost his spleen who is on chemo? Anything special?

Answer

Carolyn Vachani, RN, MSN, AOCN OncoLink Nurse Educator responds:

We would treat someone with lung cancer and no spleen just like any other patient with lung cancer. However, people without a spleen have a higher risk for certain infections and need to take some precautions because of this.

An infection can rapidly progress to sepsis and can lead to death if not treated quickly with antibiotics. Some experts believe people without a spleen should have antibiotics on hand to be started at the first sign of infection, prior to being evaluated by the healthcare team. These survivors must be aware of the importance of reporting a fever (temperature > 100.4 °) or any sign of infection to their healthcare team right away, or to go to an emergency room for evaluation if their doctor is not available. They must be sure to let any healthcare provider caring for them know that they do not have a spleen.

Survivors should wear a medic-alert bracelet noting this condition ("asplenia") and should receive annual influenza vaccines, as well as the pneumococcal and Hepatitis B vaccines. They should also receive the meningococcal and H. influenzae type b vaccines (this is not the same as the annual flu vaccine), and if bitten by a dog, cat or rodent, antibiotics are required to prevent infection with Capnocytophaga canimorsus bacteria.

When traveling, talk to your healthcare team about any necessary precautions based on where you are going. (Risks include malaria in some areas and infected ticks in Cape Cod or Nantucket Island in Massachusetts).